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Increased rates of whole body protein synthesis and breakdown in children recovering from burns
Insights
Burn injury significantly increases whole body protein synthesis and breakdown in children. This elevated protein turnover may contribute to increased heat production during recovery from thermal injury.
Area of Science:
- Metabolic responses to injury
- Pediatric critical care
- Nutritional biochemistry
Background:
- Acutely burned children exhibit significant metabolic alterations.
- Protein turnover is a key indicator of metabolic state.
- Understanding protein metabolism is crucial for optimizing recovery.
Purpose of the Study:
- To quantify whole body protein synthesis and breakdown rates in recovering burned children.
- To correlate these rates with burn severity.
- To explore the relationship between protein turnover and heat production.
Main Methods:
- Utilized constant infusion of [15N]glycine to measure protein synthesis and breakdown.
- Studied 11 acutely burned children (24 studies) and 7 healthy children (11 studies).
- Expressed rates in grams of protein per kilogram of body weight per day.
Main Results:
- Protein synthesis and breakdown rates positively correlated with burn severity (total burn surface area, third-degree burn, open wound).
- Rates were 80-100% higher in severely burned patients (≥60% total burn) compared to less severely burned (<25% total burn) or surgical patients.
- Significantly elevated rates (p<0.05) observed in patients with extensive burns.
Conclusions:
- Increased whole body protein turnover is a significant metabolic consequence of severe burn injury in children.
- Elevated protein turnover, with its high energy cost, is proposed to contribute to increased thermogenesis post-burn.
- Findings highlight the metabolic demands of recovery from thermal injury.
Abstract:
The rates of whole body protein synthesis and breakdown were determined, with the aid of a constant administration of [15N]glycine, during recovery in 11 acutely burned children, involving a total of 24 studies. Eleven studies were also conducted in seven healthy children before and after reconstructive surgery. Rates of whole body protein synthesis and breakdown, expressed as g protein/kg body weight/day, were significantly (p less than 0.05) and positiviely correlated with per cent body surface area total burn, per cent third-degree burn, and per cent open wound. These rates (synthesis, 7.1 +/- 2.1 g protein/kg/day; breakdown, 6.3 +/- 1.8 g protein/kg/day) were 80 to 100% greater (p less than 0.05) in patients with total burns greater than or equal to 60%, as compared to patients with less than 25% total burns or to the surgical patients. Because of the high energy cost of protein synthesis, it is proposed that an increased whole body protein turnover is partly responsible for the reported elevations in rates of heat production occurring in patients recovering from thermal injury.